Dental fluorosis: Everything you need to know

The change in the enamel caused by too high a concentration of fluoride during tooth development is called dental fluorosis. The most famous form of fluorosis can be recognized by the white spots on the enamel.

In severe cases, brown discolorations may appear on the enamel. The structure of the enamel may also be affected, it may contain small pits and be rough. In the mild variants, the white spots are often barely visible.

Teeth with brown spots and many white spots
Teeth with brown spots and many white spots

Causes of dental fluorosis

Dental fluorosis is an enamel defect that occurs when people take in too much fluoride during the development of their teeth. Fluorosis often results in tiny spots that range in color from white to yellow or brown.

The developmental disorder dental fluorosis mainly arises because of a disturbance in calcification of the enamel. Too much fluoride disrupts the function of the enamel-forming cells, the ameloblasts. This means that only the teeth, which are exposed to too high a concentration of fluoride during development, are at risk. Teeth and molars that have already broken through are deformed and can never develop dental fluorosis.

Symptoms of dental fluorosis

In general, teeth look smooth, shiny and creamy white. The severity of dental fluorosis is variable, from mild to severe, but common symptoms of dental fluorosis include:

Dental fluorosis treatments

Dental fluorosis can often be treated with home bleaching products. If home treatment does not produce satisfactory results, your dentist can further address the discoloration through a microabrasion treatment in the dental office. The duration and success of the treatment varies from patient to patient depending on the severity of the discoloration.

No treatment is required in mild dental fluorosis. However, in more severe cases, there are several treatment options for dental fluorosis that make affected teeth look better.

The appearance of teeth affected by moderate to severe dental fluorosis can be significantly improved by a variety of techniques. Most of them are meant to mask the spots.

dental fluorosis treatments

Such techniques can include:

  • Tooth whitening and other surface removal procedures; Note that teeth whitening can temporarily worsen the appearance of dental fluorosis.
  • MI paste, a calcium phosphate product that is sometimes combined with methods such as microabrasion to minimize tooth discoloration
  • Veneers, which are custom shells that cover the front of the teeth to enhance their appearance; These are used in severe dental fluorosis.
  • Bonding, which coats the teeth with a hard resin that binds to the enamel
  • Dental crowns

Prevention of dental fluorosis

By following the fluoride basic advice, the risk of fluorosis is very small. However, it is possible that a child still ingests too high a concentration of fluoride. This is possible, for example, due to incorrect use of fluoride tablets, or swallowing (too) much toothpaste / mouthwash. In particular, a high peak concentration, due to the intake of fluoride in a short time, must be prevented. It is therefore wise to spread the number of fluoride moments as much as possible.

Below are a number of tips to prevent fluorosis:

  • Follow the fluoride basic advice.
  • Make sure that your child spits out the toothpaste after brushing his teeth and does not swallow it. However, excessive rinsing after brushing your teeth is also not necessary.
  • Do not let your child use too much toothpaste, a pea-sized amount of toothpaste is sufficient. Children should be helped with brushing until the age of eight.
  • If your child uses extra fluoride measures, such as tablets, make sure that these are taken as spread over time as possible. Also make sure that no more than the allowed amount is taken.

Keep all fluoride-containing products such as toothpaste, mouthwashes and supplements out of the reach of young children at home. If a child ingests a large amount of fluoride in a short time, it can cause symptoms such as:

  • Vomiting
  • Abdominal pain
  • Nausea
  • Diarrhea

Try to pay attention to the amount of fluoride a person is allowed to use. See below in the table. The abbreviation for ppm stands for parts per million.

Age GroupBasic Oral Hygiene AdviceBasic Fluoride Advice
0 and 1 yearBrush toddler toothpaste once a dayFluoride toddler toothpaste (500-750 ppm fluoride)
2, 3 and 4 yearsBrush twice a day with fluoride toddler toothpasteFluoride toddler toothpaste (500-750 ppm fluoride)
5 years and olderBrush twice a day with adult fluoride toothpasteFluoride toothpaste (1,000-1,500 ppm fluoride)

Frequently asked questions

Dental fluorosis manifests itself as white spots on the permanent teeth. These spots are not harmful. Dental fluorosis is a purely aesthetic problem. Dental fluorosis on the teeth is caused by too much fluoride in the mouth for a long period of time between the ages of ½ and 4½ years. But it can only be noticed after about the 6th year, when the permanent front teeth or molars have broken through.

Yes. If it is an aesthetic problem, mild dental fluorosis can be treated by grinding away the spots. In more severe forms it is possible to stick a layer on the teeth and thus mask dental fluorosis. This causes dental tissue to be lost.

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